Pancreatic cancer has the worst prognosis among solid tumors. It is a near fatal disease and one of the most aggressive human malignancies. The management of patients with pancreatic carcinoma depends on the extent of the disease at diagnosis. Surgical resection followed by adjuvant therapy is the standard care for patients diagnosed with early-stage disease. However, the majority of patients present with advanced-stage disease that precludes surgery. Early pancreatic cancer often does not cause symptoms, and the later symptoms are usually nonspecific and varied. Therefore, pancreatic cancer is often not diagnosed until it is advanced. Prognosis for advanced stage patients is extremely poor and the impact of standard therapy is minimal. Currently, gemcitabine along with cisplatin, ephubicin, and 5-fluorouracil, is an active recommended regimen for patients with advanced pancreatic adenocarcinoma. Cisplatin alone is one of the most effective chemotherapeutic agents used for the treatment of variety of cancers including pancreatic cancer. However, the major limitation of the use of high doses to maximize the therapeutic efficacy of cisplatin is restricted due to nephrotoxicity, gastrointestinal toxicity, neurotoxicity, and ototoxicity.
DNA repair pathways have been identified as a potential target for chemotherapeutic intervention of pancreatic cancer, as well as other neoplasias. Normal cells actively repair DNA damage before going into mitosis and avoid DNA damage-induced killing of cells. In contrast, cancer cells possess defective mitotic signals and override the (G0/G1 check point, but arrest in G2/M phase and face mitotic catastrophe and death.
At present, no effective treatment exists for pancreatic cancer. New methods of treatment for treating pancreatic cancer and other neoplasias are urgently required.